July 1, 2010

Women with Moustaches

"a woman with a mustache is always happy"
-italian proverb
(referring to the fact that increased androgens = increased libido...and extra hair)

At work this week we've talked with a lot of women about libido. It's fascinating the things women feel able to talk about pre-pelvic exam vs. post-pelvic exam. In the pre-exam discussion, I have noticed that women sit up very straight and even though they answer all questions - and sometimes ask their own - there's a propriety that sort of divides the patient and the doctor. But there's something that changes - I won't say relaxes because that's definitely not the right word - but maybe shifts? - while a woman sits with her legs spread wide and lets you look at her most intimate parts - most of which she has not seen herself.

For example, the cervix looks like a soft, silky pillow with a small hole in the center about the size of the tip of a chopstick. That's where a baby's head is when they say "it's CROWNING". Yes. Out of the hole the size of a chopstick in the center of the soft, silky, pillow-like part. This thought occurs to me every time I see a cervix and I stare in wonder and awe. As I see more and more cervices, it also consistently occurs to me that I have not seen my own cervix. Someday I'm going to have to figure that one out.

The doctor I'm working with makes terrible jokes throughout the entire exam. Not terrible in an inappropriate way, just not entirely funny. We talked about this and she said that gynecologists and urologists have to make jokes because they have to keep people both distracted and comfortable while talking with them and touching their most sensitive parts.

Which I think is a valid point.

After the pelvic exam, we leave the room so the woman can re-robe, and then re-enter to review the results of the exam with the patient and answer any questions. For some reason it is at this point when all the good questions come out. Everything from, "sooooo...my boyfriend doesn't really ejaculate. ever. is that normal?" to "what's trichimonas?" to "have you ever met a woman whose gone this long without having sex? I mean, I'm honestly asking you, have you?" and "how common are hemorrhoids anyways?"

It's pretty hard to talk about the female reproductive system without talking about sex. And it's pretty hard to talk about sex without talking about relationships. So this is my favorite part of working with a gynecologist - I really feel that I'm hearing (and sorting through) women's most intimate fears and concerns.

Even though it's my favorite part, it always leaves my mind reeling from the day, so I'm grateful to have the hour bike ride home along the river to take everything I've seen and heard during the day and just let it roll around itself in my head.

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